Comparative study between general anesthesia with and without fascial regional block in coronary artery bypass graft surgery: prospective and randomized study between conventional surgery via sternotomy and minimally invasive surgery via lateral thoracic

Abstract

Submuscular regional blockages in deep fascia guided by ultrasound and special needles in cardiac surgery, have gained enormous importance in order to shorten intubation time, facilitate respiratory physiotherapy, and decrease opioid use with its negative consequences. Regional anesthesia is part of the current concept of multimodal analgesia in surgery, within the processes of acceleration of postoperative recovery. The aim of this randomized study is to compare regional anesthesia in the fascial planes, versus local anesthesia in the subcutaneous planes in the primary outcomes: patient-reported pain score, respiratory complications (atelectasis, pneumonic foci), comfort, postoperative, postoperative analgesia, mechanical ventilation time and opioid consumption. Secondary outcomes, ICU time and hospitalization. From a total of 100 patients eligible for myocardial revascularization, 50 patients will be randomized in each arm (sternotomy) and (lateral thoracotomy). Randomization consists of regional anesthesia of the deep fascia, where the nerves responsible for innervation of the upper chest by the anesthesiologist, versus local anesthesia in the incisions by the surgeon. (AU)